Health and Human Services Secretary Alex Azar and the Trump administration are proposing new regulations for short-term health insurance plans, focusing on value-based care as a priority. According to reports, Azar's speech focused on value-based care, an approach in which doctors and hospitals are reimbursed by private health insurance and the government for how well patients emerge after a medical procedure versus the amount of care provided. The proposed rule — which would allow people to … [Read more...] about Trump proposes new rule for affordable Healthcare: Limited duration health plan for 364 day
Texas, and 19 other states battle Affordable Care Act as “unconstitutional” in Federal Court
More than 8.8 million Americans are enrolled in the Affordable Care Act healthcare law spearheaded by President Barack Obama. An unpopular mandate of the Affordable Care Act, a tax penalty for the uninsured was repealed by a bill passed by Congress and signed by President Trump in December. Now, Texas is among 20 states where 20 Republican state attorneys general are suing to overturn the law, asking a federal court to hold the Affordable Care Act's individual mandate and the … [Read more...] about Texas, and 19 other states battle Affordable Care Act as “unconstitutional” in Federal Court
“Medicare Extra for All” plan proposed for universal healthcare
A new plan signals revived interest in public options and even Medicare-for-all. To address healthcare challenges, the Center for American Progress proposes a new system— Medicare Extra that would include important enhancements to the current Medicare program: an out-of-pocket limit, coverage of dental care and hearing aids, and integrated drug benefits. Medicare Extra would be available to all Americans, regardless of income, health status, age, or insurance status. According to reports, the … [Read more...] about “Medicare Extra for All” plan proposed for universal healthcare
Elderly patients at risk at Nursing homes that overmedicate
National reports by Human rights advocates say that nursing homes are overprescribing antipsychotics to patients. According to the latest data from the federal Centers for Medicare & Medicaid Services, known as CMS, the percentage of long-term nursing home residents being given antipsychotic drugs dropped from about 24 percent in late 2011 to under 16 percent last year. Yet advocacy groups reveal that misuse of drugs remains a major problem in nursing facilities. The findings outlined in a … [Read more...] about Elderly patients at risk at Nursing homes that overmedicate
Government’s two-year spending plan includes $1.9 billion Nursing home cuts
According to reports, nursing home cuts will freeze skilled nursing facilities' share of the “market basket” at a 2.4% increase in October. The Congressional Budget Office (CBO) had previously projected a 2.7% hike, though the final rate won't be set until CMS announces its proposed rules for 2019. The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) President and CEO Mark Parkinson issued the following statement regarding the Senate budget proposal: “We are … [Read more...] about Government’s two-year spending plan includes $1.9 billion Nursing home cuts
New Hospice Care Law allows Physician Assistants to manage Hospice care for Medicare Patients
Beginning on Jan. 1, 2019, physician assistants can now supervise cardiac and pulmonary rehabilitation programs under the Medicare program as well as provide and manage Hospice care for terminally ill Medicare patients. The extended medical privileges for physicians assistants could benefit Medicare beneficiaries who live in medically underserved and rural communities, where a PA might be the only available medical professional to provide some services, according to news reports. According to … [Read more...] about New Hospice Care Law allows Physician Assistants to manage Hospice care for Medicare Patients
Health and Human Services Commission (HHSC) adopted new rules for Disabled Patients
Provider Letter 18-04 The new rule describes the requirement of a facility to allow a resident to use a wheelchair self-release seatbelt if the resident meets certain conditions. Addressed to providers including Assisted Living Facilities (ALFs), Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICFs/IID), and Nursing Facilities (NFs). The new rules implement §322.0515, Texas Health and Safety Code, as added by House Bill (HB) 284 of the 85th … [Read more...] about Health and Human Services Commission (HHSC) adopted new rules for Disabled Patients
CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
CMS is adding flexibility to their expansion of benefits by redefining health-related supplemental benefits to include services that increase health and improve quality of life, including coverage of non-skilled in-home supports and more. Hospice care and palliative care are considered as well as supplemental benefits down the road. Benefits will only be available to some of the participants of Medicare Advantage plans. These benefits will not be extended to original Medicare. Supplemental … [Read more...] about CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
Changes to HHSC-Approved Diagnostic Codes for Persons with Related Conditions List
Information Letter No. 18-04 This letter provides an annual update to the International Classification of Diseases, Tenth Revision (ICD-10) code set as of October 1, 2017, which includes new and revised ICD-10 diagnostic codes. Health and Human Services Commission (HHSC) has revised the HHSC-Approved Diagnostic Codes for Persons with Related Conditions. List of Invalid ICD-10 Related Conditions Codes: The following ICD-10 diagnoses codes are no longer valid and were deleted from the … [Read more...] about Changes to HHSC-Approved Diagnostic Codes for Persons with Related Conditions List
Nursing Facilities – Immediate Threat Violations
PL 18-03-NF - This guidance for Nursing providers was issued by HHSC to address licensure violations and when violations counts as one of the three violations forming the basis for the license revocation that is required by §19.2107 in 40 Texas Administrative Code Chapter 19. b) Except as provided by subsection (d) of this section, the executive commissioner revokes a license if DADS finds that: (1) the license holder has committed three violations in §19.601(b) or (c) of this chapter … [Read more...] about Nursing Facilities – Immediate Threat Violations
